Monday, July 12, 2010

Hot Spots in Dogs

One of the most common problems I see in the summer is a skin condition called “Hot Spots”.   Also known as pyoderma, acute moist dermatitis or summer eczema, hot spots are usually a disease of dogs with long hair or those with dense undercoats. It is often caused by a local allergic reaction to a specific irritation such as insect bites, ear infections or anything that disturbs the healthy integrity of skin. This summer is unusually warm and the occurrence of this condition has become more frequent.
Hot Spots can seemingly appear spontaneously anywhere on a dog's body and the area involved can rapidly spread. This moist, raw skin disorder has a variety of causes but the most consistent factor is bacteria. There are a number of kinds of bacteria that can be cultured from a "hot spot" and fortunately most respond to oral and topical antibiotics. Anything that irritates or breaks the skin can create the environment for bacterial contamination if the skin surface has just a bit of moisture on it. That moisture can be present from a recently given bath, from swimming or being out in the rain, from rolling in wet grass or even from a slightly oozing sore that provides nutrients for bacteria. For some reason, cats rarely acquire Hot Spots; dermatological problems in our feline friends are far less common than in the dog.

The causes of hot spots include: Allergies, ear infections, poor grooming (Thick matted haircoats),burs or plant awns, osteoarthritic conditions that cause immobilization, any condition that causes excessive licking or self utilization, and anal gland infections.
The mainstay of treatment is antibiotics to control the infection. These are usually given systemically but topical antibiotics can be used in localized infections. Topical antibacterial shampoos, washes, lotions and creams can be used to augment antibiotics and reduce bacterial populations once the infection is controlled. Pus and other debris should be flushed and cleaned out of ears, wounds, abscesses etc. Foreign bodies or implants should be removed. Most infections, however, will recur unless the underlying cause is diagnosed and treated.

On many occasions, the infection has advanced to the point that treatment requires light sedation or anesthesia.. If treated early enough this can be avoided.  The problem with this infection is that as it progresses, the desire to lick and scratch make it worse and progressively more severe.

More than 95% of superficial pyodermas are associated with Staphylococcus intermedius, which have a fairly predictable antibiotic sensitivity pattern. It is therefore not necessary to perform routine culture and antibiotic sensitivity testing on most cases as they will respond to a sensible choice of antibiotic.

I routinely treat these patients by clipping and cleaning the affected areas and determining the cause of the infection. If infected ears are causing the lesion under the ear, it must be treated also or the infection will reappear.

Antibiotics and steroids are often given at the same time.  The steroid is used to stop the desire to lick or scratch the affected skin. On many occasions an “Elizabethan” collar is attached to the collar. Your veterinarian will also prescribe a topical antibiotic/steroid crème which will be applied on the sore areas.

If  caught in the very early stages, sometimes over the counter medicines can provide relief.  A steroid called Cortaid Cream and an antibiotic ointment called Neosporin may effectively treat this condition. One must exercise extreme caution that this skin disease does not progress.  If left untreated the dog may continue to mutilate the affected area and cause a condition called acral pruritic granuloma (Lick Granuloma). When this occurs, the skin becomes pathologically thickened and can be very resistant to treatment.

Some pets are helped by clipping hair and good grooming during these times. Always monitor for ear infections and seek the help of your veterinarian when your pet experiences a condition that causes extreme itchiness and a sore that appears moist or shows evidence of pus.

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